Framing substance use disorders among forcibly displaced people through a syndemics lens.

Abstract Syndemics are synergistically interacting epidemics (for example, the epidemics of substance use disorders and forced displacement) in a particular context with shared drivers such as pre-existing political, structural, social and health conditions. Policymakers may ask what the risks of and needs are for forcibly displaced people with regards to substance use disorder (SUD). Working from a syndemics framework, we would argue that multiple risk and resiliency factors relating to both forced displacement and SUD work synergistically, and impact more significantly upon some populations than others. These risk factors include structural inequality and racism, social deprivation, violence, homelessness, trauma, childhood adversity, and co-morbid physical and mental health disorders. Individuals may become vulnerable while experiencing displacement, during transition, settlement or resettlement, and also through their life across and across generations. In this perspective, our answers to policymakers becomes more nuanced. We may argue for integrated, multi-modal interventions, cross-disciplinary collaborations, cross-pollination of ideas and knowledge and embedding lived experience to bridge gaps and make use of limited resources in sustainable ways. This presentation will detail aspects of the application of a syndemic lens to the evidence base on SUD among forcibly displaced people and generate discussion on what scientists, clinicians and policymakers can and may do with these insights. Disclosure of Interest None Declared


Abstract:
The leaky pipeline is a visual metaphor for the underrepresentation of women in leadership positions in Academic Psychiatry despite their over-representation in medical schools, residency programs, and junior academic positions. The presentation focuses on the key obstacles that pertain to personal and societal attitudes and institutional barriers and proposes empirically tested and pragmatic solutions.
Disclosure of Interest: None Declared S0024 2. Case scenarios 1: Trauma based approach: from instability to stability F. Baessler Psychosomatics, University Clinic and Heidelberg Academy of Sciences andHumanities, Heidelberg, Germany doi: 10.1192/j.eurpsy.2023.61 Abstract: This presentation is titled " Case scenarios 1: Trauma based approach: from instability to stability". You will be given a case based oriented insight into the relationship between substance use disorder and forced displacement and treatment options that are based upon the trauma some has been experienced. A focus will be on factors that contribute on psychological stability in extreme situations. Thus you will be presented preliminary results of our ongoing study funded by the Heidelberg Academy of Sciences and Humanities that dedicated to the question of how mental stability and health-related quality of life of individuals change over time.

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Mentoring for improving gender equality in academic psychiatry A. Riecher-Rössler Medical Faculty, University of Basel, Basel, Switzerland doi: 10.1192/j.eurpsy.2023 Abstract: Although in many countries in the meantime more women than men choose medicine and later psychiatry for their training, key positions in hospitals and research are still mainly held by men. The professional career of women is impeded not only by institutional, but also by psychological barriers such as gender role behavior and gender role stereotypes. Mentoring can help young women to overcome these barriers. But usually mentoring starts too late. As studies have shown, important decisions about future career steps are taken already towards the end of medical studies. Therefore, gender sensitive teaching and mentoring should start already at university and should not only address young women, but also young men as potential partners and future colleagues -especially regarding their gender role behavior and stereotypes. Mentoring programs considering gender-specific needs should be implemented in the regular teaching during medical studies and in psychiatric training. Furthermore, women should be coached during their further career steps since there is not only a "glass ceiling" that excludes young women from achieving leadership roles. When they finally have achieved such a role, women often face further difficulties stemming from gender stereotypes and traditional gender roles. University teachers and employers should be addressed, as well as politicians. Otherwise, psychiatry not only loses a great potential of talents, but might also miss the chance of reforms towards a more gender-sensitive psychiatry and psychotherapy.

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Framing substance use disorders among forcibly displaced people through a syndemics lens. Abstract: Syndemics are synergistically interacting epidemics (for example, the epidemics of substance use disorders and forced displacement) in a particular context with shared drivers such as pre-existing political, structural, social and health conditions. Policymakers may ask what the risks of and needs are for forcibly displaced people with regards to substance use disorder (SUD). Working from a syndemics framework, we would argue that multiple risk and resiliency factors relating to both forced displacement and SUD work synergistically, and impact more significantly upon some populations than others. These risk factors include structural inequality and racism, social deprivation, violence, homelessness, trauma, childhood adversity, and co-morbid physical and mental health disorders. Individuals may become vulnerable while experiencing displacement, during transition, settlement or resettlement, and also through their life across and across generations. In this perspective, our answers to policymakers becomes more nuanced. We may argue for integrated, multi-modal interventions, crossdisciplinary collaborations, cross-pollination of ideas and knowledge and embedding lived experience to bridge gaps and make use of limited resources in sustainable ways. This presentation will detail aspects of the application of a syndemic lens to the evidence base on SUD among forcibly displaced people and generate discussion on what scientists, clinicians and policymakers can and may do with these insights. Abstract: Journal editors can promote gender equality in various ways. The main ones are consideration of gender when inviting editorial board members, peer reviewers, and authors of solicited opinion pieces or reviews. As in many areas, the problem can be that the pool of suitable women is perceived to be small and the same women are asked to perform multiple tasks in addition to their academic and clinical duties. Journal editors need to seek women who are less well known but competent for the task required. To increase the pool of qualified candidates, editors should promote training using existing resources, such as online peer reviewer courses, or develop in-house initiatives, such as The Lancet Psychiatry's Editorial Board Development Programme. It is important to make public commitments to gender balance, for example as part of a diversity pledge, with specific targets, and to collect and report data with regular updates. Gender balance should be an integral part of information templates in manuscript handling systems, such as asking authors and peer reviewers to consider women when recommending alternative peer reviewers. Where relevant, journal editors can also consider gender balance in their use of images, cover art, podcast or interview subjects, profiles, news and features, and social media content.

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The efficacy of cognitive remediation in children and adolescents: results from a new meta-analysis. Abstract: This presentation will share data from a new metaanalysis of RCT studies using cognitive remediation to treat children and adolescents with ADHD. For this matter, 25 studies were accessed, and results will focus on outcomes immediately after the end of the program and in follow-up. Outcomes include subjective measures of functioning (through validated scales), neuropsychological measurements and academic performance. Comparisons regarding length of training, intensity, concomitant use of pharmacological treatments will also be provided. These findings will build on previous meta-analysis on the issue that were performed in the past. Abstract: Plasticity is the ability to modify brain and behavior, ultimately promoting an amplification of the impact of the environment on the individual's mental health. Thus, plasticity is not beneficial per se but its value depends on contextual factors. High plasticity is beneficial in favorable, but can be detrimental in adverse living conditions, while the opposite applies to low plasticity. Consequently, resilience and vulnerability are not univocally associated to high or low plasticity. Here I will present recent findings supporting this theoretical framework and showing the role of the serotonin system in enhancing plasticity. First, we explored the Sequenced Treatment Alternatives to Relieve Depression-STAR*D dataset and analyzed the outcome of the SSRI citalopram treatment according to socioeconomic status (SES) and SSRI dosage. The results showed that SSRIs are plasticity-enhancer drugs as they amplify the influence of the living conditions on mood in a dosedependent fashion. Second, we exploited a meta analytic approach to investigate the contribution of the serotonin-transporter-linked promoter region (5-HTTLPR) to depression vulnerability considering time as moderating factor. We found that the 5-HTTLPR x stress interaction is a dynamic process, producing different effects at different time points and confirming that individuals with high plasticity are both at higher risk and more capable to recover from depression. Overall, our findings indicate that treatments and conditions enhancing plasticity have a therapeutic value that depends on context.